| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 50 BRAINTREE HILL OFFICE PARK BRAINTREE, MA 02184 | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | $420 | $23K | $24K | 1.69% |
| STEVEN S. RODRIGUES3 | 57 MEADOW LARK DRIVE CRANSTON, RI 02921 | AFLAC | $490 | $27 | $517 | 3.20% |
| THOMAS E. HODGE AND OTHER AGENTS3 | 53 WILTON AVENUE PAWTUCKET, RI 02867 | AFLAC | $381 | $5 | $386 | 2.39% |
| MARK S TAGLIAFERRI3 Filed as: MARK S. TAGLIAFERRI | 4 LEIGHAS LANE COVENTRY, RI 02816 | AFLAC | $240 | $0 | $240 | 1.49% |
| STEVEN J. PHILLIPS3 | 110 JEFFERSON BOULEVARD WARWICK, RI 02888 | AFLAC | $158 | $0 | $158 | 0.98% |
| LYNNE F. KULISCH3 | 103 LAUREL HILL AVENUE SUITE A PASCOAG, RI 02859 | AFLAC | $152 | $0 | $152 | 0.94% |
| WILLIAM H KIRK3 Filed as: WILLIAM H. KIRK | 110 JEFFERSON BOULEVARD WARWICK, RI 02888 | AFLAC | $104 | $5 | $109 | 0.68% |
| MARK S TAGLIAFERRI3 Filed as: MARK S. TAGLIAFERRI | 110 JEFFERSON BOULEVARD WARWICK, RI 02888 | AFLAC | $105 | $0 | $105 | 0.65% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 62937 VIRGINIA BEACH, VA 23466 | BOSTON MUTUAL LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 231 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 232 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 261 | $1.4M |
| Dental | DELTA DENTAL OF RHODE ISLAND | 276 | $79K |
| Vision | AFLAC | 20 | $16K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 231 | $32K |
| Short-term disability | AFLAC | 20 | $16K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF RHODE ISLAND | 261 | $1.4M |
| Other(2 contracts, 2 carriers) | AFLAC | 231 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 276 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.